Clinical analysis of tonsillotomy combined with adenoidectomy for children with OSA
Objective To investigate the effect of tonsillotomy combined with adenoidectomy in the treatment of obstructive sleep apnea(OSA)in children.Methods From June 2017 to June 2020,230 children with OSA who were hospitalized in the Department of Otolaryngology,Nanjing Tongren Hospital were included,and 130 children who underwent tonsillotomy combined with adenoidectomy were included in the observation group,while 100 children who underwent tonsillectomy combined with adenoidectomy were included in the observation group.The difference of preoperative and postoperative treatment effect between the two groups and the difference of postoperative treatment effect between the two groups were compared respectively.Results The wounds of the observation group and the observation group healed well,the postoperative AHI decreased significantly,and the lowest oxygen saturation increased significantly.The differences of the indexes with each group before and after surgery were statistically significant(AHI:Z value of the observation group=13.076 P value<0.001,Z value of the observation group=15.125 P value<0.001;LSaO2:Z value of the observation group=9.892 P value<0.001,Z value of the observation group=9.035 P value<0.001;).There was no significant difference in AHI and lowest oxygen saturation between the observation group and the observation group before operation and at 6 months after operation(AHI before operation:Z value=1.621 Pvalue=0.105,AHI at 6 months after operation:Z value=1.660 P value=0.097;LSaO2 before operation:Z value=0.853 Pvalue=0.394,LSaO2 at 6 months after operation:Z value=1.540 P value=0.123),while the observation group had less postoperative pain and shorter time to resume normal eating compared with the observation group,and the difference was statistically significant(VAS score comparison:Z value=13.180 P value<0.001).The incidence of postoperative bleeding,postoperative infection and posterior pharyngeal wall lymphoid hyperplasia in the observation group was lower than that in the observation group,and the differences were statistically significant(postoperative bleeding:Z=4.501,P=0.034;postoperative infection:Z value=4.812 P value=0.028;posterior pharyngeal wall lymphoid hyperplasia:Z value=5.821 P value=0.016).Conclusion Tonsillotomy combined with adenoidectomy for children with OSA has good surgical effect,mild postoperative pain reaction,less postoperative complications,and good medical experience,which is worthy of promotion and application.
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